Carotid arterial stiffness in overweight and obese Indian children

Pandit, Deepa; Kinare, Arun S.; Chiplonkar, Shashi; Khadilkar, Anuradha; Khadilkar, Vaman

doi:10.1515/jpem.2011.086

Cited by 31 publications

(29 citation statements)

References 25 publications

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“…Indeed, the author's previous reports have provided supporting evidence that the development of hypertension is associated with higher PWV in the carotid arteries of children with highest odds. 31 Mean PWV was reported as 4.6 ± 0.5 m s À1 in Australian school-children having higher body fat, 32 which is on par with children with MS in the present study.…”

Section: Discussionsupporting

confidence: 44%

Efficacy of a continuous metabolic syndrome score in Indian children for detecting subclinical atherosclerotic risk

et al. 2011

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Objective: To evaluate the continuous metabolic syndrome score (cMetS) in Indian children and to investigate its relationship with the risk of carotid arterial stiffness. Methods: Data on weight, height, mean arterial pressure, serum lipids, insulin, glucose, carotid intima-media thickness and stiffness parameters, that is, pulse wave velocity (PWV), elasticity modulus (Ep), stiffness index (b) and arterial compliance (AC), were assessed in 236 children (6-17 years) from Pune city, India. cMetS was computed using standardized Z-scores for metabolic syndrome (MS) components. cMetS cutoff was obtained by receiver operating characteristic curve analysis across MS components. Results: cMetS was lowest (À3.6 ± 2.0) in normal children and highest (3.3 ± 2.4) in MS children. cMetS increased progressively with number of risk components. The cutoff of cMetS yielding maximal sensitivity (80%) and specificity (94%) for predicting the presence of MS was À0.8 (area under the curve ¼ 0.921 (95% CI: 0.877-0.964)). In children with cMetS above À0.8, average PWV (4.3±0.6 m s À1 ), b (3.8±1.2) and Ep (50.4±14.5 kPa) were significantly higher than the respective values (3.7 ± 0.5 m s À1 ; 3.4 ± 0.8; 37.0 ± 10.0 kPa) in children with cMetS below À0.8, whereas AC was lower (1.2 ± 0.5 mm 2 kPa À1 ) in children with cMetS above À0.8 as against AC (1.4±0.3 mm 2 kPa À1 ) in children with cMetS below À0.8 (Po0.05), demonstrating the risk of stiffness with increasing score. Pearson's correlation coefficients of cMetS with PWV (r ¼ 0.575), b (r ¼ 0.347), AC (r ¼ À0.267) and Ep (r ¼ 0.530) were statistically significant (Po0.01). Conclusion: Results demonstrate the usefulness of cMetS over individual MS components as a better tool for assessment of atherosclerotic risk in children.

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Section: Discussionsupporting

confidence: 44%

Efficacy of a continuous metabolic syndrome score in Indian children for detecting subclinical atherosclerotic risk

et al. 2011

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“…Reported absolute BMI ranged from 23.9 to 37.2 (obese, youngest to eldest cohort) and 15.5 to 22.3 (controls). Only 3 studies reported BMI z-scores, [19][20][21] and 1 study used it in their regression analysis but did not report the mean values. 12 As such, we were unable to assess the linear relationship between arterial stiffness and BMI z-scores, and children were assessed based on their categorization as obese or as a healthy BMI control.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…We did not assess linear relationships between arterial stiffness and absolute BMI because of the different ages and sex of the children in the studies. Boys and girls were analyzed as 1 group in all but 1 study 20 ; thus, our analysis is not able to distinguish sex-specific differences. A summary of the characteristics for the 15 studies is provided in Table 2.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…The 12 studies reporting central PWV 12,[19][20][21][22][23][24][25][26][27]30,32 were of good methodological quality (Downs and Black scores ranged from 14 to 16). All but 2 of these papers 12,21 reported increased arterial stiffness in the children with obesity compared with healthy BMI controls.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…12,23,27,30,32 Six of these studies determined PWV using the carotid-femoral wave forms gated to the ECG, 12,21,24,27,30,32 2 studies used Doppler ultrasound traces from the ascending and descending aorta, 23,25 whereas 4 studies used a single-point method of PWV determination using carotid β stiffness, diastolic blood pressure, and blood density. 19,20,22,26 There were 4 studies assessing carotid β stiffness, 19,20,26,28 all reporting a higher carotid β stiffness index in the children with obesity. Similarly, in the 4 studies assessing aortic β stiffness, 25,27,29,31 all reported a higher aortic β stiffness index in the children with obesity.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Obesity and Arterial Stiffness in Children

Coté

Phillips

Harris

et al. 2015

ATVB

130

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Objective-Childhood obesity is associated with risk factors for cardiovascular disease. Arterial stiffness is considered one of the earliest detectable measures of vascular damage. There is controversy in the literature regarding the effects of childhood obesity on arterial stiffness. The objective of this study is to systematically review the literature and to conduct a meta-analysis comparing measures of central arterial stiffness in children and adolescents with obesity to healthy body mass index controls. Approach and Results-Literature searches were conducted using databases (eg, MEDLINE, EMBASE) and citations cross-referenced. Studies assessing central pulse wave velocity or β-stiffness index were included. A random effects meta-analysis of the standardized mean difference and 95% confidence intervals in arterial stiffness between children with obesity and control children was performed for each arterial stiffness measure. A total of 523 studies were identified. Fifteen case-control studies were included, with 2237 children/adolescents (1281 with obesity, 956 healthy body mass index controls) between 5 and 24 years of age. All studies measuring carotid and aortic β-stiffness index and 10/12 studies measuring central pulse wave velocity reported greater arterial stiffness in children/adolescents with obesity compared with controls. A random effects meta-analysis was performed revealing a significant effect of obesity on pulse wave velocity (standardized mean difference=0.718; 95% confidence interval=0.291-1.415), carotid β-stiffness index (0.862; 0.323-1.402), and aortic β stiffness index (1.017; 0.419-1.615). Conclusion-These findings indicate that child/adolescent obesity is associated with greater arterial stiffness. However, further research is needed to address confounders, such as pubertal status, that may affect this relationship in children. In the future, these techniques may be useful in risk stratification and guiding clinical management of obese children to optimize cardiovascular outcomes.

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Epicardial Fat Thickness Correlates With Carotid Intima-Media Thickness, Arterial Stiffness, and Cardiac Geometry in Children and Adolescents

Cabrera-Rego¹,

Iacobellis

Castillo-Herrera³

et al. 2013

Pediatr Cardiol

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To determine the association between epicardial fat thickness and carotid arterial stiffness, carotid intima-media thickness (CMIT), left atrial (LA) volume, and left-ventricular (LV) geometry parameters in obese children and adolescents compared with controls. A case-control study was performed in 96 children and adolescents (obese n = 66, controls n = 30) age 9-16 years old (38 female and 58 male, mean age 11.7 ± 2.8 years) undergoing transthoracic echocardiography and carotid artery ultrasound. Clinical, anthropometric, and biochemical determinations were also recorded. Epicardial fat thickness (2.76 ± 1.2 vs. 1.36 ± 0.7 mm, p < 0.001), LA volume (35.7 ± 13.2 vs. 28.9 ± 9.8 mL, p = 0.008), LV mass (118.3 ± 38.6 vs. 96.4 ± 35.4 mL, p = 0.008), CIMT (0.48 ± 0.07 vs. 0.44 ± 0.05 mm, p = 0.019), and local pulse wave velocity (LPWV; 3.7 ± 0.5 vs. 3.2 ± 0.4 m/seg, p = 0.007) were significantly increased in obese children and adolescents compared with controls. Epicardial fat showed a significant and positive correlation with LA volume, LV mass, and LPWV as well as a significant and independent association with increased CIMT (odds ratio (OR) = 3.19 [1.88-7.99], p = 0.005) in the study population. Epicardial fat thickness is linked to obesity, carotid subclinical atherosclerosis, and cardiac geometry parameters and might be a useful tool for the cardiovascular risk stratification in children and adolescents.

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Carotid arterial stiffness in overweight and obese Indian children

Abstract: PWV may be considered an important marker for evaluation of early functional changes of the carotid artery in children and adolescents.

Cited by 31 publications

References 25 publications

Efficacy of a continuous metabolic syndrome score in Indian children for detecting subclinical atherosclerotic risk

Efficacy of a continuous metabolic syndrome score in Indian children for detecting subclinical atherosclerotic risk

Obesity and Arterial Stiffness in Children

Epicardial Fat Thickness Correlates With Carotid Intima-Media Thickness, Arterial Stiffness, and Cardiac Geometry in Children and Adolescents

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